In Adult ADHD: The Big Picture, we discussed the specifics about different types of ADHD, what causes ADHD, how it impacts brain function, common problems related to adult ADHD and more. It might be helpful to follow the progression of the disorder from childhood to get a better picture. Suffice it to say that some kids with ADHD have symptoms that are so severe s/he is identified in pre-school or day care. Others are usually identified in the first three years of grade school.
Childhood and Adolescence
ADHD-Hyperactive Type: When you think of the stereotypical ADHD child, the image of a 9-year-old boy often comes to mind. In our mind’s eye, this little guy moves at warp speed, leaving a wake of destruction. He is loud, rambunctious and often a bit defiant. He talks back, refuses to cooperate, interrupts others and has little social or emotional awareness.
He may be the class clown who gets by with this behavior because he is cute and precocious, or the playground bully who takes what he wants. Poor impulse control and hyperactivity are the hallmarks of this type of ADHD. When it comes to regulating emotions, you might expect this fellow to be quick to anger, taking offense at even the least offensive slights.
If someone gets this kid evaluated and finds the right treatment, there’s a good chance he may graduate. Hopefully, teachers who are well-versed in the management of ADHD will help him stay in school and learn how to work with his specific brain type. In a perfect world, his parents’ marriage will survive and he will have support at home in a family where one or both will work with him to complete his schoolwork and actually get it to the teacher.
Smart parents will find an outlet for some of that energy and angst, possibly sports, acting, art or other creative outlets. A good coach/mentor will work with the attitude and outbursts to give the kid a chance at success. Perhaps a savvy therapist or medical provider will help the family find the right mix of diet and supplements to keep his brain working at optimal performance.
ADHD-Inattentive Type: Your imaginary ADHD friend may be a 10-year-old girl. She may be quiet and a bit day-dreamy. During class, she might often gaze out the window instead of doing the assignment. You’ll often see her doodling when she is supposed to be listening. She does not have overt behavioral problems, but her work in school is not in accord with her potential.
She gets along well with her peers, but you might notice she is somewhat uncoordinated. The little girl may seem a bit spacey at times – forgetting her lunch money or losing her workbook. You could worry that there is an underlying problem, and consult with the school psychologist or talk to her parents about her lack of motivation and not applying herself to her studies.
The school psychologist may do some testing and find that your young friend has ADHD-Inattentive Type. With any luck, the school will develop a plan to provide her with extra support in class. Maybe the parents will find a local support group where they will learn more about the condition and ways to help her succeed. She may require extra time on tests, or need to do homework in an environment that is specially designed for her success.
Our young friend might try medication for use during school hours and homework. Hopefully, she will also get connected with some enjoyable groups or clubs where she will excel. Perhaps the biggest hurdle for her will be not getting overlooked as her mild temperament and agreeable behavior could make it easier for her to ‘fall between the cracks’ of the school system.
ADHD-Combined Type: Some of us have symptoms of both hyperactivity and inattention.
From looking at my report cards throughout elementary, junior and high school, it seems safe to say that most of the symptoms were present most of the time when I was in school. There is an explanation about ADHD that helps me make sense of that.
One theory of ADHD that is widely believed suggests that because of the lower levels of dopamine and norepinephrine, the brain is ‘sleepy’. According to that theory, kids who have hyperactive symptoms are literally trying to stay awake. If these kids can get still, they often fall asleep or get very drowsy.
Dopamine is secreted when we focus on something we like or find stimulating. Stimulation is what the sleepy brain needs to concentrate. This is why many children with ADHD who have trouble sitting still or paying attention in class can often watch television or play video games for hours. That paradox causes many parents to ignore warnings from teachers about their child’s ability to concentrate in school. Those kids who seem to be daydreaming, spacey or lethargic are indeed dealing with the effects of sleepy brainwaves.
The Transition to Adulthood
While our central nervous systems are developing and the adults are working hard to get us through our youth, many of us figure out how to sit in our seats when needed. Most of us can keep quiet until it is our turn to talk (unless it is taking too long). We may even become more adept at reading social cues and understanding some of the nuances of social interactions. Those who struggle with inattention often learn coping skills to help with staying on task.
Many of the symptoms that seemed so problematic in childhood (school and peer relations) are easier to manage (for some). But, with the advent of adulthood comes new responsibilities, physical changes and competing expectations. This often requires new skills and abilities that are not in our repertoire. It is during the initial transition to adulthood that many young people with ADHD get lost on their journey.
Read more about Adult ADHD on the College Campus and in the Workplace, and Adult ADHD: Emotional Regulation and other Soft Signs.
Low, Keath. "How Do Stimulants for ADHD Work?" About.com ADD / ADHD. Web. 30 Oct. 2013.
"The ADHD Sleepy Brain." Realivze Health. Web. 30 Oct. 2013.